A randomized controlled trial of the efficacy of cosmetic talc compared with iodopovidone for chemical pleurodesis

Agarwal, Ritesh; Paul, Abinash S; Aggarwal, Ashutosh N.; Gupta, Dheeraj; Jindal, Surinder K.

doi:10.1111/j.1440-1843.2011.01999.x

Cited by 50 publications

(35 citation statements)

References 31 publications

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“…Instillation of the sclerosing agent is thereafter followed by a profound inflammatory response between the layers, which, in turn, result in fibrin accumulation and pleural fibrosis. A variety of different chemicals (talc, bleomycin, tetracycline, iodopovide and others) and bacterial products (from Corynobactum parvum, Streptococcus pyogenes, Staphylococcus aureus and others) have been used in clinical studies to achieve pleurodesis [70][71][72][73]. The profound inflammatory response they cause may result in adverse events such as pain and fever but it is believed that the level of inflammation correlates with the likelihood of successful pleurodesis [74].…”

Section: Pleurodesismentioning

confidence: 99%

Malignant pleural effusion: from bench to bedside

et al. 2016

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Malignant pleural effusion (MPE) is a common but serious condition that is related with poor quality of life, morbidity and mortality. Its incidence and associated healthcare costs are rising and its management remains palliative, with median survival ranging from 3 to 12 months. During the last decade there has been significant progress in unravelling the pathophysiology of MPE, as well as its diagnostics, imaging, and management. Nowadays, formerly bed-ridden patients are genotyped, phenotyped, and treated on an ambulatory basis. This article attempts to provide a comprehensive overview of current advances in MPE from bench to bedside. In addition, it highlights unanswered questions in current clinical practice and suggests future directions for basic and clinical research in the field. @ERSpublications This review provides up to date knowledge for malignant pleural effusion covering aspects from bench to bedside http://ow.ly/10w7vN

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Section: Pleurodesismentioning

confidence: 99%

Malignant pleural effusion: from bench to bedside

et al. 2016

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“…It occurred in 33 patients (55%) and was classified as serious in 11 of them (18%). Pain had already been reported as a complication of pleurodesis with iodopovidone as well as with other sclerosing agents [12,13,14,15,16,17,18,19]. Agarwal et al [16] found a median VAS score of 50.5 (range 10-95) after iodopovidone pleurodesis through the chest tube in patients with MPE.…”

Section: Discussionmentioning

confidence: 99%

“…Iodopovidone has been reported as a good alternative to talc pleurodesis, with an efficacy rate around 90% and a low number of complications [15,16,17,18,19]. Moreover, it is easily obtained, easy to use, and inexpensive.…”

Section: Introductionmentioning

confidence: 99%

Safety Profile of the Use of Iodopovidone for Pleurodesis in Patients with Malignant Pleural Effusion

Neto¹,

Terra²,

Teixeira³

et al. 2015

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Background: Iodopovidone is an alternative agent used to promote pleurodesis in patients with malignant pleural effusion (MPE). However, safety is a concern, and many authors still reject its use. Objectives: Our main objective is to describe the occurrence of common and severe adverse events after pleurodesis with two different doses of iodopovidone in patients with MPE. Our secondary objective is to evaluate dose dependency, efficacy, quality of life, and systemic inflammation. Methods: We conducted a double-blind, randomized clinical trial including patients with recurrent MPE. Patients underwent chest tube insertion and were randomized into two groups according to the doses of iodopovidone: group 1 received 1% iodopovidone, and group 2 received 2% iodopovidone. During follow-up, adverse events, inflammatory markers, quality of life, and imaging exams were systematically evaluated and registered. Results: Sixty patients were analyzed (55 females, 5 males, median age 55.9 years). Overall, 227 adverse events possibly related to pleurodesis were registered, including 47 serious adverse events (in 34 patients). Pleuritic pain and hypertensive peaks were the most frequently observed serious adverse events (11 and 10 episodes, respectively). Grade 3/4 metabolic events such as hyponatremia and an increase in alkaline phosphatase, AST and ALT levels were also common. C-reactive protein (CRP) levels increased substantially and peaked 48 h after pleurodesis. No difference was observed between groups with regard to adverse events, CRP levels, efficacy, or quality of life. Conclusions: Adverse events after iodopovidone pleurodesis in patients with MPE are common and similar in the two doses studied.

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“…Yeni Zelanda'da yapılan bir çalışmada talk plörodezin komplikasyonları araştırılmış, çoğu minör olmak üzere %52 oranında komplikasyon saptanmıştırr. Bu çalışmada, taşikardi, ateş, ağrı ve dispne en sık görülen komplikasyonlar iken, biri ARDS'ye, biri taşikardiye bağlı olmak üzere iki ölüm bildirilmiştir (Tablo 3) (48)(49)(50)(51)(52)(53)(54)(55)(56).…”

Section: Plörodezde Komplikasyonlar Nelerdir?unclassified

Management of Malignant Pleural Effusions: Minimally Invasive Techniques

Parmaksız¹

2013

Solunum

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ÖZETPlevral sıvıda malign hücreler görülmesi ya da plevra biyopsisinde tümör tespit edilmesi ile tanı konan malign plevral efüzyon-lar (MPE) genellikle kötü prognoz ve kısa yaşam beklentisi ile ilişkilidir. MPE'nin tedavisinde amaç, hastanın semptomlarını gidererek yaşam kalitesini arttırmaktır. Bu amaçla, çeşitli tedavi seçenekleri mevcuttur. En sık kullanılan yöntem plöredez olmakla beraber gözlem, terapötik torasentez, uzun süreli kateter drenajı, plöroperitoneal şant ve plörektomi de tedavi amacıyla kullanılabilmektedir. Bu derlemede MPE tedavisinde kullanılan minimal invaziv yöntemlerin endikasyonları, uygulanışı, etkinliği ve komplikasyonları değerlendirilmiştir. GİRİŞ VE AMAÇTüm plevral efüzyonların yaklaşık %22'sini oluşturan malign plevral efüzyon, malign tümörlerin doğrudan komşuluk yoluyla veya hematojen yolla plevraya yayılması ile oluşur ve plevral doku ya da sıvıda malign hücrelerin saptanması ile tanı alır. MPE plevranın primer tümörlerine bağlı olabileceği gibi, çoğunlukla intratorasik ya da ekstratorasik organ tümör-lerinden metastaz yoluyla oluşur. Plevraya en sık metastaz yapan tümörler akciğer, meme kanseri ve lenfomalardır (Şekil 1), (1, 2). MPE'lerde en sık histopatolojik tanı adenokarsinom olmakla beraber diğer tümör tipleri de etyolojide yer alabilir (3).Tümör tipine bağlı olmakla beraber MPE'de medyan survi 4-12 aydır (1, 4). Malign hastalıkların seyri sırasında mediastinal lenf nodlarının tutulumu ve buna bağlı lenfatik obstrüksiyon, bronş obstrüksiyonu, pulmoner emboli, superior vena kava sendromu ya da onkotik basınç azalmasına bağlı olarak ortaya çıkan plevral sıvılar ise paramalign sıvı olarak adlandırılır. MPE'lerin tedavisi hastalığa neden olan primer tümörün tipi, sıvının miktarı, semptom varlığı gibi birçok faktöre bağlı olarak değişir. Örne-ğin küçük hücreli akciğer kanseri, lenfoma, meme kanseri gibi malignitelere bağlı sıvılarda kemoterapi etkin olabilir. Bununla birlikte, çoğu hasta lokal tedaviye ihtiyaç duymaktadır. En sık kullanılan lokal tedavi yöntemleri, terapötik torasentez, uzun süreli kateter drenajı ve plöredezdir. Yazımızda bu yöntemler Solunum t Elif Torun Parmaksız 5

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A randomized controlled trial of the efficacy of cosmetic talc compared with iodopovidone for chemical pleurodesis

Abstract: Iodopovidone and cosmetic talc are equally efficacious and safe agents for chemical pleurodesis.

Cited by 50 publications

References 31 publications

Malignant pleural effusion: from bench to bedside

Malignant pleural effusion: from bench to bedside

Safety Profile of the Use of Iodopovidone for Pleurodesis in Patients with Malignant Pleural Effusion

Management of Malignant Pleural Effusions: Minimally Invasive Techniques

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